Herpes simplex virus (HSV)-suppressive therapy decreases plasma and genital HIV-1 levels in HSV-2/HIV-1 coinfected women: a randomized, placebo-controlled, cross-over trial.
A randomized cross-over trial of herpes simplex virus type 2 (HSV-2)-suppressive therapy (valacyclovir, 500 mg twice daily, or placebo for 8 weeks, a 2-week washout period, then the alternative therapy for 8 weeks) was conducted among 20 Peruvian women coinfected with HSV-2 and human immunodeficiency virus type 1 (HIV-1) who were not on antiretroviral therapy. Plasma samples (obtained weekly) and endocervical swab specimens (obtained thrice weekly) were collected for HIV-1 RNA polymerase chain reaction. Plasma HIV-1 level was significantly lower during the valacyclovir arm, compared with the placebo arm (-0.26 log10 copies/mL, a 45% decrease [P < .001]), as was cervical HIV-1 level (-0.35 log10 copies/swab, a 55% decrease [P < .001]). Suppressive HSV-2 therapy has the potential to reduce HIV-1 infectiousness and slow HIV-1 disease progression.
Baeten
Jared M
JM
Department of Global Health, University of Washington, Seattle, WA 98104, USA. jbaeten@u.washington.edu
Strick
Lara B
LB
Lucchetti
Aldo
A
Whittington
William L H
WL
Sanchez
Jorge
J
Coombs
Robert W
RW
Magaret
Amalia
A
Wald
Anna
A
Corey
Lawrence
L
Celum
Connie
C
D000212:Acyclovir / Q000031:analogs & derivatives / Q000627:therapeutic use; D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use; D018592:Cross-Over Studies; D005260:Female; D015658:HIV Infections / Q000097:blood* / Q000150:complications* / Q000821:virology; D015497:HIV-1 / Q000302:isolation & purification*; D006561:Herpes Simplex / Q000150:complications* / Q000188:drug therapy*; D018258:Herpesvirus 2, Human / Q000302:isolation & purification*; D006801:Humans; D008875:Middle Aged; D000077483:Valacyclovir; D014633:Valine / Q000031:analogs & derivatives / Q000627:therapeutic use; D014779:Virus Replication / Q000187:drug effects
D000998:Antiviral Agents; D014633:Valine; D000077483:Valacyclovir; D000212:Acyclovir